Obesity and Osteoarthritis of the Hip

This chapter explores the relationship between obesity and osteoarthritis of the hip joint, focusing on the role of obesity in the degeneration of the hip joint, considerations for total hip arthroplasty (THA) in obese patients, and the postoperative complications and outcomes faced by these patients. Obesity is on the rise globally and is predicted to become a substantial financial burden on the healthcare system by 2030. Obesity is strongly linked to the development of osteoarthritis via increased mechanical loading, joint surface damage, and increased inflammation. The chapter highlights the importance of appropriate patient selection and preoperative optimisation in obese patients, including lifestyle modifications and the evidence for preoperative bariatric surgery in some cases. It also discusses the potential harmful effects of obesity cutoffs in preoperative planning. Furthermore, it discusses the challenges faced by surgeons in performing THA on obese patients, such as increased surgical risks, choice of surgical approach, potential intra- and postoperative complications, and also potential occupational hazards for the surgical team. Lastly, the chapter emphasises the need for further research in areas such as pre-habilitation, antibiotic prophylaxis, and implant selection to improve the outcomes for obese patients undergoing THA.